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P430 Predictors of interest in switching from daily to on-demand HIV Pre-Exposure Prophylaxis (PrEP) among australians
  1. Vincent Cornelisse,
  2. Luxi Lal,
  3. Brian Price,
  4. Edwina Wright
  1. The Alfred Hospital, Department of Infectious Diseases, Melbourne, Australia


Background The only HIV pre-exposure prophylaxis (PrEP) regimen approved in Australia is daily co-formulated tenofovir and emtricitabine. As an alternative, on-demand PrEP could offer benefits, including lower pill burden for people having sex infrequently. We surveyed PrEPX study participants to measure interest in switching from daily PrEP to on-demand PrEP.

Methods The survey asked 15 questions on demographics, sexual behaviour, interest in on-demand PrEP, and reasons for interest. Univariate regression analyses assessed associations between interest in on-demand PrEP and other survey questions, and questions with significant (p<0.1) association in univariate analysis were entered in a multivariate regression model.

Results 970 responses were complete. Respondents’ median age was 39 years, and 99.6% were male. All had taken daily PrEP, but 14% had ceased PrEP. 469 respondents (48%; 95%CI 45–52) reported interest in on-demand PrEP. In multivariate analysis, interest in on-demand PrEP was independently associated with having ceased PrEP (aOR 2.0, p<0.001), dissatisfaction with daily PrEP (aOR 2.0, p=0.027), difficulty remembering to take pills every day (aOR 1.6, p=0.029), infrequently having sex that conferred HIV risk (aOR 3.7, p<0.001), concerns about long term toxicity from PrEP (aOR 2.7, p<0.001), and having no prior knowledge of on-demand PrEP (aOR 1.6, p<0.004). Respondents who were not interested in on-demand PrEP (N=501) reported concerns about its effectiveness (67%), concerns about not remembering to take a dose at least 2 hours before sex (58%), having unplanned sex (15%), and having frequent sex and hence needing to take PrEP daily (2%).

Conclusion This is the first study of interest in switching from daily to on-demand PrEP. Half of respondents were interested, and interest was most strongly associated with infrequency of sex and concerns about long-term toxicity. However, many respondents had concerns about the effectiveness of on-demand PrEP, and about forgetting to take on-demand PrEP at least two hours before sex.

Disclosure No significant relationships.

  • ART
  • PrEP

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